The overall aim of this proposal is for Wayne State University (WSU) to be a part of the NICHD Collaborative Pediatric Critical Care Research Network. The Network will bring together a core of pediatric intensivists with the research expertise and clinical skill to investigate the safety, efficacy, and risk/benefit/cost ratios of novel treatments and management strategies for critically ill and injured children. The Network will conduct a wide range of transdisciplinary research including epidemiologic studies of life-threatening diseases, descriptive and translational studies of the pathophysiology of inflammation and organ failure, randomized trials of drugs, procedures and other interventions specifically evaluating their effect on long-term outcomes, and behavioral studies of the effect of critical illness on the child and his/her family. The Pediatric Critical Care Medicine (PCCM) faculty at WSU is responsible for the state-of-the-art, multidisciplinary 20-bed PICU that has 1,400 medical and surgical admissions annually. The PCCM faculty has conducted many randomized trials and observational studies in the PICU, and participated in other multicenter research networks. The faculty has a long history of collaboration with pediatric surgeons. Strengths of WSU include membership in the NICHD Pediatric Pharmacology Research Network, the Neonatal Research Network, the Maternal Fetal Network, the Children's Oncology Group, and its capability for long-term follow-up of patients in clinical trials. The concept proposal will test the hypothesis that a physician-parent postmortem conference 3 months after a child's death in the PICU can reduce the likelihood of pathological grief and subsequent family break-up. Aim 1 will develop the postmortem conference as a strategic communication encounter. Aim 2 will evaluate the longitudinal effect of the postmortem conference on pathological grief, psychological distress and marital dysfunction in bereaved parents. Aim 3 will evaluate risk factors for pathological grief, psychological distress and marital dysfunction, and the effect of the postmortem conference in the identified high-risk groups.